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Periodic Limb Movement

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3041. Constraint-Based Therapy to Improve Motor Function in Children With Cerebral Palsy

was derived from basic research with animal and human subjects. Randomized, controlled studies indicate that it can substantially reduce the motor deficit of adult patients with mild to moderately severe chronic strokes and can increase their independence over a period of years. CI therapy involves motor restriction of the less affected upper extremity for a period of 2 to 3 weeks while concurrently training the more affected upper limb. This gives rise to concentrated, repetitive use of the more affected (...) ). Recruitment status was: Recruiting First Posted : May 22, 2003 Last Update Posted : June 24, 2005 Sponsor: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Information provided by: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Study Details Study Description Go to Brief Summary: Pediatric Constraint-Induced (CI) Movement therapy is a rehabilitation program designed to improve motor function in children with partial paralysis

2003 Clinical Trials

3042. Combination Anti-Platelet and Anti-Coagulation Treatment After Lysis of Ischemic Stroke Trial (CATALIST)

is identified, that dose of eptifibatide will be investigated in a subsequent randomized placebo-controlled trial. MRI and CT are used as radiological measures of brain hemorrhage. The NIH Stroke Scale (NIHSS) is used to measure neurological worsening or recovery. The NIHSS is a 15-item neurologic examination stroke scale used to evaluate the effect of acute stroke on the levels of consciousness, language, neglect, visual-field loss, extra ocular movement, motor strength, ataxia, dysarthria, and sensory (...) ). The NIHSS is a 15-item neurologic examination stroke scale used to evaluate the effect of acute stroke on the levels of consciousness, language, neglect, visual-field loss, extra ocular movement, motor strength, ataxia, dysarthria, and sensory loss. A trained observer rates the patient's ability to answer questions and perform activities. Ratings for each of the 15 items are scored. Patients who have a score of 0 are considered to have "normal" examination. Patients with a score of 40 have the most

2003 Clinical Trials

3043. The Role of Dopamine in Motor Learning in Healthy Subjects and Patients With Parkinson's Disease

of a stimulus (e.g., white circle) below one of the markers by pressing the spatially corresponding key. About a second later, the next stimulus will be displayed below one of the other markers, and so on. Reaction times and accuracy will be recorded. After 3 to 10 minutes of practice (one block), there will be a rest period during which the computer will display information about the subject's accuracy of movements and reaction time. Then, a new block will start. There will be about 6 to 20 practice blocks (...) as the electrical activity during training. Indeed, patients with Parkinson's disease frequently complain of slowness and early fatigue during movements. These symptoms are believed to be related to a decrease of dopamine in the brain which may be associated with abnormalities in cerebral electrical activity. Adult patients with Parkinson's disease who are right-handed, do not have dementia, and are not depressed may be eligible for this study. Healthy volunteers who match patients in age, gender, handedness

2002 Clinical Trials

3044. GM1 Ganglioside Effects on Parkinson's Disease

than idiopathic PD. A tremor score on the UPDRS motor scale of >5. Tremor score greater than 3 in an individual limb. High-dose vitamin E therapy (more than 1000 I.U./day) any time during the period starting 3 months prior baseline. Transient ischemic attack any time during the period starting 6 months prior baseline. Hx of 2 or more strokes. Hx of any stroke that resulted in motor deficit, movement disorder, ataxia, cognitive impairment, or a hemi-inattention syndrome. Any stroke with residua (...) for at least 3 months prior to Screening. Mini Mental State Exam score > 25. Beck Depression Inventory score < 10. Signed informed consent. Exclusion criteria: Abrupt onset of Parkinsonism. Failure of Parkinsonian symptoms to have responded to l-dopa. Motor symptoms (such as peak dose dyskinesias (UPDRS score > 3), & random on-off phenomenon, other than end-of-dose wearing-off, persistently fluctuating over a 6 month or longer period, in response to l-dopa. Hx of findings of any movement disorder other

2002 Clinical Trials

3045. Safety and Efficacy of Oral Fampridine-SR for the Treatment of Spasticity Resulting From Spinal Cord Injury

impulses. As a result, subjects with an incomplete spinal cord injury may have spasticity which is muscle spasms or muscle stiffness that makes movement difficult. Fampridine-SR is an experimental drug that increases the ability of the nerve to conduct electrical impulses. This study will examine the effects of Fampridine-SR on moderate to severe lower-limb spasticity, as well as the effects on bodily functions such as bladder control, bowel function and sexual function. The study will also examine (...) (twice daily) Placebo Comparator: Placebo Other: Placebo Placebo Outcome Measures Go to Primary Outcome Measures : Double-blind Change From Baseline in Ashworth Score Evaluating Spasticity [ Time Frame: Baseline (visits 2,3) average score days 7,14 and double blind treatment period (visits 4-7) average score days 28-98 ] The Ashworth Score is the average rating (based on a scale of 1 to 5) of four lower extremity muscle groups; left and right knee flexors and extensors (hamstrings and quadriceps

2002 Clinical Trials

3046. Effects of Treating Obstructive Sleep Apnea in Epilepsy

, demyelination, metabolic illness, or progressive degenerative disease. Non-epileptic spells (e.g., pseudoseizures) alone or in combination with epileptic seizures. Narcolepsy or another primary sleep disorder that requires intervention with medications and which may affect results of study (e.g., severe periodic limb movement disorder). Effectively treated OSA or prior exposure to continuous positive airway pressure. History of poor compliance with antiepileptic medications. Current treatment with the vagus (...) nerve stimulator. Pregnancy. A significant history of medical or psychiatric disease which may impair participation in the trial. A history of alcohol or drug abuse during the one-year period prior to trial participation. Evidence of medical instability (e.g., congestive heart failure, cardiac arrhythmias, pulmonary disease) due to obstructive sleep apnea. Subjects who are unaware of the majority of their seizures and lack a reliable witness. Greater than ten seizures a day. Contacts and Locations

2002 Clinical Trials

3047. Effect of Ropinirole on Spinal Cord Reflexes and Restless Legs Syndrome

disturbances. Ropinirole affects chemical messengers thought to be involved in spinal cord function and in modulating RLS symptoms. Healthy normal volunteers and patients with RLS between 18 and 80 years of age may be eligible for this study. Patients must have mild to moderate RLS and periodic limb movements. All candidates will be screened with a medical history, physical and neurological evaluations, electromyogram (see below), polysomnogram (see below), electrocardiogram (ECG), and blood and urine (...) provided by: National Institutes of Health Clinical Center (CC) Study Details Study Description Go to Brief Summary: This study will examine the effects of the drug Ropinirole on spinal cord reflexes and on symptoms of restless legs syndrome (RLS). Patients with RLS have uncomfortable sensations in the legs, usually in the evening or early part of the night. Most patients also have periodic involuntary leg movements. The condition tends to worsen over time, resulting in severe discomfort and sleep

2003 Clinical Trials

3048. Tactile/kinesthetic stimulation effects on preterm neonates. (Abstract)

of the limbs for three, 15-minute periods per day for a 10 days. The stimulated neonates averaged a 47% greater weight gain per day (mean 25 g v 17 g), were more active and alert during sleep/wake behavior observations, and showed more mature habituation, orientation, motor, and range of state behavior on the Brazelton scale than control infants. Finally, their hospital stay was 6 days shorter, yielding a cost savings of approximately $3,000 per infant. These data suggest that tactile/kinesthetic (...) Tactile/kinesthetic stimulation effects on preterm neonates. Tactile/kinesthetic stimulation was given to 20 preterm neonates (mean gestational age, 31 weeks; mean birth weight, 1,280 g; mean time in neonatal intensive care unit, 20 days) during transitional ("grower") nursery care, and their growth, sleep-wake behavior, and Brazelton scale performance was compared with a group of 20 control neonates. The tactile/kinesthetic stimulation consisted of body stroking and passive movements

1986 Pediatrics Controlled trial quality: uncertain

3049. Postoperative epidural fentanyl infusion--is the addition of 0.1% bupivacaine of benefit? Full Text available with Trip Pro

) bupivacaine. After an initial 50 micrograms bolus of fentanyl, infusion rate was adjusted according to need between 2 and 10 ml/hr for 48 hours. The two groups (n = 40) were similar with regard to age, weight and preoperative status. Analgesia both at rest and with movement were significantly better in group FB (P < 0.0001) during the first 24 hours postoperatively, the greatest difference occurring in the 4 to 16 hour period. There was no significant difference between groups from 24 to 48 hours (...) postoperatively. Fentanyl utilisation was significantly lower in group FB (median 41 versus 53 micrograms/hr, P < 0.001), although clinically the fentanyl dose-sparing effect of bupivacaine was small and did not reduce opioid-induced side-effects. There was no significant difference between groups with respect to side-effects or lower limb weakness, although fewer patients in group FB could be mobilised on the morning of the first postoperative day (P < 0.01). Nevertheless, all study patients were ambulant

1994 Anaesthesia and intensive care Controlled trial quality: predicted high

3050. Motor signs of wakefulness during general anaesthesia with propofol, isoflurane and flunitrazepam/fentanyl and midlatency auditory evoked potentials. (Abstract)

every 20 to 30 s (group 3). Heart rate and arterial pressure were recorded continuously. Purposeful movements of the limbs, eye-opening or other movements as well as coughing were documented as motor signs of intra-operative wakefulness. Auditory evoked potentials were recorded in the awake state, after induction and during maintenance of general anaesthesia. Motor signs of intra-operative wakefulness occurred statistically significantly more often in the patients of the flunitrazepam/fentanyl group (...) than in those of the propofol and isoflurane group. There was no correlation between wakefulness and cardiocirculatory parameters. In the awake patients midlatency auditory evoked potentials had high peak to peak amplitudes and a periodic waveform.(ABSTRACT TRUNCATED AT 250 WORDS)

1994 Anaesthesia Controlled trial quality: uncertain

3051. Randomized, double-blind, placebo-controlled study of clonidine in restless legs syndrome. (Abstract)

minutes) (p = 0.028). There were no significant changes in total sleep time, stage 1 and 2 sleep, sleep efficiency, awakenings, arousals or periodic limb movements in sleep. There was a nonstatistical trend toward and increase in stage 3 and 4 sleep and a decrease in motor activity as measured by actigraphic recordings. Globally, seven out of 10 patients felt clonidine was more effective than placebo. Four patients chose to continue clonidine after the study. Clonidine may be an effective treatment (...) for RLS patients who don't have large numbers of sleep-disrupting periodic limb movements but have delayed sleep onset due to leg sensations and subsequent motor restlessness.

1996 Sleep Controlled trial quality: uncertain

3052. Long-term, nightly benzodiazepine treatment of injurious parasomnias and other disorders of disrupted nocturnal sleep in 170 adults. (Abstract)

sleepwalking and sleep terrors (69); rapid eye movement sleep behavior disorder (52); chronic, severe insomnia (25); and restless legs syndrome/periodic limb movement disorder (24).Complete/substantial control of the sleep disorders was achieved by 146 patients (86%); 8% had adverse effects requiring medication changes; 2% had relapses of alcohol or chemical abuse requiring hospitalization; another 2% at times misused their medications. A total of 136 patients received clonazepam nightly for a mean 3.5 (...) Long-term, nightly benzodiazepine treatment of injurious parasomnias and other disorders of disrupted nocturnal sleep in 170 adults. To assess the efficacy, dose stability, safety, and abuse potential of long-term, nightly benzodiazepine treatment of chronic disorders of disrupted nocturnal sleep.During a 12-year period, one author evaluated and treated 170 adult referrals for > or = 6 months with nightly benzodiazepine therapy for longstanding, sleep-disruptive disorders: injurious

1996 The American journal of medicine Controlled trial quality: uncertain

3053. Longitudinal effects of nortriptyline on EEG sleep and the likelihood of recurrence in elderly depressed patients. Full Text available with Trip Pro

and EEG sleep measures and the recurrence of major depression. Our results show that nortriptyline acutely and persistently decreased REM sleep, increased phasic REM activity, decreased sleep apnea, and had no effect on periodic limb movements during sleep. Recurrence on maintenance nortriptyline was associated with lower phasic REM activity during early continuation therapy, but EEG sleep measures did not predict recurrence during placebo maintenance therapy. Patients treated with nortriptyline had

1996 Neuropsychopharmacology Controlled trial quality: uncertain

3054. Efficacy of diclofenac in lateral epicondylitis of the elbow also treated with immobilization. The University of Montreal Orthopaedic Research Group. (Abstract)

21 days.The experimental group was treated with a daily dose of diclofenac sodium (150 mg) for 28 days, while the control group received a placebo during the same period. In addition, both groups were immobilized in a cast for 14 days and were told not to perform repetitive movements of the involved limb for 21 days.Measuring instruments consisted of grip strength measurements with a squeeze dynamometer, a visual analog pain scale, a visual analog function scale, and an 8-item pain-free function (...) of lateral epicondylitis beyond and over rest in an experimental group compared with a control group after 4 weeks of treatment.Recruitment from urban general practices and referrals to 4 university hospitals.During a 1-year period, 206 subjects aged 18 to 60 years with lateral epicondylitis were recruited from the clientele treated by family physicians. Thirty subjects refused to participate and 47 presented with exclusion criteria, leaving 129 subjects who entered the study. One subject withdrew after

1997 Archives of family medicine Controlled trial quality: predicted high

3055. Open-label trial of oral nalmefene therapy for the pruritus of cholestasis. (Abstract)

of limb movements, was recorded continuously for 24-hour periods before and during treatment with an initial ameliorating dose of nalmefene. Simultaneously, during these periods, visual analogue scores (VASs) of pruritus were recorded every 4 hours while patients were awake. The dose of nalmefene, which initially was 2 mg orally twice daily, was increased during the study, usually until a satisfactory clinical response was achieved. Five patients experienced a transient opioid withdrawal-like reaction

1998 Hepatology

3056. Effects of creatine monohydrate ingestion in sedentary and weight-trained older adults. (Abstract)

programme. The strength training programme consisted of three sets of eight repetitions at 80% of one-repetition maximum, for leg press, leg extension and chest press, 3 days a week. The 52-day supplementation programme consisted of 20 g of creatine monohydrate (or glucose) and 8 g of glucose per day for the initial 5 days followed by 3 g of creatine monohydrate (or glucose), and 2 g of glucose per day. Prior to and after the training and supplementation periods, body mass, body fat, lower limb muscular (...) volume, 1-, 12-repetitions maxima and isometric intermittent endurance tests for leg press, leg extension and chest press were determined. In all groups, no significant changes in anthropometric parameters were observed. For all movements, the increases in 1- and 12-repetitions maxima were greater (P < 0.02) in trained than control subjects. No significant interactions (supplementation/training/time) were observed for the 1-, 12-repetitions maxima, and the isometric intermittent endurance, whatever

1998 Acta physiologica Scandinavica Controlled trial quality: uncertain

3057. Randomized, double-blind, placebo-controlled trial of pergolide in restless legs syndrome. (Abstract)

of treatment (days 17 and 18).As a group, pergolide recipients showed significant improvement clinically and statistically in all outcome measures when compared with baseline or with placebo treatment. On the other hand, placebo treatment led to no significant improvements in any outcome measures.Pergolide treatment significantly improved clinical symptoms and sleep efficiency, and reduced periodic limb movements of sleep in patients with RLS. (...) schedule that ranged from 0.05 to 0.65 mg/day. Outcome variables included the patient's rating of symptom improvement, duration of RLS symptoms throughout the day, and objective sleep assessments from an all-night polysomnogram (percent sleep efficiency and periodic leg movements). Baseline was assessed for 2 days before starting treatment. Dose adjustments were made over the first 14 days and were then held constant for 5 days, with repeat assessment for treatment effects on the last 2 days

1998 Neurology Controlled trial quality: predicted high

3058. Neonatal outcome after prolonged rupture of the membranes starting in the second trimester. Full Text available with Trip Pro

compressive limb abnormalities, all of which responded to passive physiotherapy. Pulmonary hypoplasia was significantly associated with earlier onset of rupture of the membranes, and the absence of fetal breathing movements. Compressive limb abnormalities were significantly associated with longer periods of oligohydramnios. We conclude that premature rupture of the membranes, even with onset in the second trimester, may be associated with a favourable outcome and this may be predicted by the persistence (...) of fetal breathing movements. We therefore, recommend expectant management of such pregnancies, but suggest elective delivery at 34 weeks to limit fetal exposure to uterine compression and minimise the risks of prematurity.

1988 Archives of Disease in Childhood

3059. Diagnosis and treatment of sleep disorders: a brief review for clinicians Full Text available with Trip Pro

circadian rhythm disorders are described in conjunction with interventions, including chronotherapy and light therapy. The diagnosis and treatment of restless legs syndrome/periodic limb movement disorder is addressed. Attention is focused on obstructive sleep apnea and upper airway resistance syndrome, and their treatment. The constellation of symptoms and findings in narcolepsy are reviewed together with diagnostic testing and therapy, Parasomnias, including sleep terrors, somnambulism, and rapid eye (...) movement (REM) behavior sleep disorders are described, together with associated laboratory testing results and treatment.

2003 Dialogues in Clinical Neuroscience

3060. Tardive dyskinesia. Full Text available with Trip Pro

Tardive dyskinesia. Tardive dyskinesia is a potentially irreversible syndrome of involuntary hyperkinetic movements that occur in predisposed persons receiving extended neuroleptic (antipsychotic) drug therapy. It is usually characterized by choreoathetoid dyskinesias in the orofacial, limb, and truncal regions, but subtypes of this syndrome may include tardive dystonia and tardive akathisia. Although the mechanisms underlying the pathogenesis and pathophysiology of this disorder are unproven (...) , altered dopaminergic functions will likely play a role in any explanation of it. Tardive dyskinesia develops in 20% of neuroleptic-treated patients, but high-risk groups such as the elderly have substantially higher rates. Risk factors include age, female sex, affective disorders, and probably those without psychotic diagnoses, including patients receiving drugs with antidopaminergic activity for nausea or gastrointestinal dysfunction for extended periods. Total drug exposure is positively correlated

1990 Western Journal of Medicine

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